For years some doctors and many concerned lay individuals have
advised that bed rest has a beneficial effect on the outcome of
multiple pregnancies. This advice has not been uniformly accepted,
however, primarily because the studies which have examined twin
mothers in a prospective randomized manner have failed to show
a clear-cut affect from bed rest.

Happily, some investigators have
continued their work in this area. Among them, are Dr. K.T.M.
Schneider and his colleague, Dr. Renata Hutch. These individuals
have been studying the effect of quiet standing for almost a decade.
By quiet standing, they mean the kind of activity that so many
women are typically involved in, such as clerks, bank tellers,
nurses, teachers, housewives, etc. (in other words, quiet standing
refers to low-exertion activities which would keep a woman on
her feet).

Drs. Schneider and Hutch observed
changes in women who were on their feet for prolonged periods
that were comparable to the well known “inferior vena cava
syndrome.” Any woman who has given birth or who has been
pregnant through the third trimester knows that lying flat on
one’s back produces weird effects. The woman may become
short of breath, may be dizzy and/or feel faint. Relief is simple:
turn on the left side.

Drs. Schneider and Hutch noted
that when pregnant women stand for prolonged periods of time,
the uterus exerts constant pressure on the vena cava. The net
result is the same as if the uterus were lying on the vena cava
when the woman is flat on her back. The difference, however, is
that when the woman is standing the body has only one compensatory
mechanism, and that is to initiate uterine contractions! By initiating
a contraction of the uterus, the pressure on the vena cava is
relieved and a normal, rather than an abnormal physiologic situation
continues. This happens because gravity pushes the uterus downward
between the bony pelvis in the front of the abdomen and the vena
cava, which lies behind the uterus in front of the bony spinal
column.

In other words, contractions
are triggered by the woman being in the standing position for
a prolonged time. Needless to say, with the added pressure produced
by twins, triplets and more, this phenomenon is dramatically increased;
bed rest and the reduction of physical activity becomes a matter
of grave concern.

So there you have it, ladies!
Don’t expect your doctors to believe this research any more
than they believe other research that explains some of the beneficial
aspects of the care of multiple pregnancies. Don’t worry
about your doctors, because you won’t be able to change
them. Just think about yourself and your babies and what is best
for you and for them. If you do, you will recognize that prolonged
standing is a risk for preterm contractions, and you will do something
about it. When pregnant with triplets or more, bed rest should
be a priority. As your multiple gestation pregnancy advances,
engaging in activities which require you to be on your feet could
quickly spell disaster.